People are exposed to numerous chemicals daily through the products we use, the food we eat, and the air we breathe. This has been demonstrated by research that indicates virtually all people living in the industrialized world have numerous chemicals in their blood, which has led to growing scientific and public concern over the potential health implications of these exposures. Chemicals, such as phthalates, are a significant public health concern because decades of research have linked them to a wide range of health effects. This dissertation contributes to the literature by assessing how sociodemographic factors influence exposure to phthalate metabolites (Paper 1), and how exposures to phthalates individually (Paper 2) and in combination (Paper 3) affect antibody concentrations (i.e. titers) against organisms that cause infectious diseases.

This dissertation utilized data from five cross-sectional cycles of the National Health and Nutrition Examination Survey, a nationally representative sample of U.S. residents one year and old, to prepare three dissertation papers. The first paper assessed how sociodemographic characteristics influenced exposure distributions with a focus on birthplace, age, and sex/gender differences. This study found that overall phthalate exposure has decreased for most metabolites examined between 2003 and 2012. While exposure to phthalates was ubiquitous, foreign-born persons generally had greater exposure compared to U.S.-born persons, particularly for low molecular weight (LMW) metabolites; males typically had greater risk of exposure to high molecular weight (HMW) phthalates; and young persons had greater overall exposure compared to adults.

The second paper tested associations between single phthalate metabolite and individual antibody measures against measles virus, mumps virus, rubella virus, poliovirus, Epstein-Bar virus, and Toxoplasma gondii. When examining the association between single metabolites and individual antibody measures, exposure to LMW phthalates was generally positively associated with measles, poliovirus, and Epstein-Barr virus antibodies, respectively. Conversely, HMW phthalates were inversely associated with both rubella and poliovirus antibodies. Males typically experienced immune enhancement while suppression was primarily observed in females.

Lastly, the third paper evaluated how co-exposures to phthalate influenced multiple antibody titers simultaneously. This was accomplished with structural equation modeling that showed LMW phthalate metabolites were associated with immune enhancement while HMW phthalates were associated with immune suppression with the exception of mono-ethyl phthalate. If associations are causal, exposure to HMW phthalates could increase a person’s risk to infectious diseases while exposure to LMW phthalates could be immunoprotective, or they could increase susceptibility to autoimmunity and/or allergy.

In this paper, we examine recent research in the area of neighborhood effects on children’s development. We begin by reviewing the literature on the mechanisms through which neighborhoods may influence child development. Then we consider four issues which are fundamental to neighborhood effects research: (1) the definition of "neighborhood," (2) which aspects of neighborhood environments are important and how they should be measured, (3) neighborhood selection, and (4) children’s residential mobility. Next, we assess recent empirical work on neighborhood effects. Recent reviews by Sampson et al. (2002), Ginter et al. (2000), Duncan and Raudenbush (1999, 2000), and Leventhal and Brooks-Gunn (2000) catalog studies since 1990 and provide thorough reviews of their results. Rather than duplicate their efforts, we briefly summarize and compare their conclusions and then focus on the results of selected studies which provide novel approaches or insights. The final section of the paper summarizes the current state of knowledge about poor neighborhoods and their role in the intergenerational transmission of poverty.

Kenya has had a history of promoting both family planning and efforts against gender-based violence. However, intimate partner violence (IPV) remains a significant factor in women’s lives. Although experience of IPV has been shown to create a significant burden on reproductive health outcomes, less work has focused on the impact of IPV on women’s contraceptive use particularly in Kenya. Using the data from the 2003, 2008-09, and 2014 Kenya Demographic and Health Surveys (Kenya National Bureau of Statistics (KNBS) & ICF Macro 2004, 2010, 2015) this dissertation focused on the association between IPV, fertility intentions, women’s autonomy, and contraceptive use. I integrate the theory of gender and power and the social-ecological model to examine the association between IPV and contraceptive use.

In the first study I focus on the impact of IPV on women’s fertility intentions. IPV experience increases the likelihood women would want to limit their childbearing as compared to wanting to space births or have children soon. This indicates that women would be less likely to want to raise children in an environment they are unsure is safe or supportive, a concept I call the uncertain futures hypothesis.

The second study examines whether exposure to IPV reduced contraceptive use. I find that IPV did not uniformly reduce contraceptive use. Instead, IPV exposure decreased the likelihood of traditional contraceptive use but increased the likelihood of modern contraceptive use. This lends further credence to the possibility that women are making planful contraceptive decisions in IPV situations.

In the final study I examine whether healthcare decision making, representing a facet of women’s autonomy, mediates the relationship between intimate partner violence and recent modern contraceptive use. This study found that there no mediated effect of healthcare decision making. However, healthcare decision-making remained significant in all models underscoring the need to consider ability to make healthcare decisions as a possible barrier to contraceptive access for women in abusive partnerships.

This dissertation improves the evidence that IPV may facilitate women’s greater use of modern contraceptives in African contexts. It also underscores the need to consider IPV experiences when advising women on family planning.

This paper examines the effects of family and neighborhood factors on child health in one of the largest urban areas in the United States, Los Angeles County. We use data from a new representative survey of neighborhoods and households in L.A.—the Los Angeles Family and Neighborhood Survey, or L.A.FANS—to examine the effects of family and neighborhood characteristics on child health status. A particular focus is on differences between Latinos and other race/ethnic groups as well as differences by duration of family residence in the U.S. and other key factors. We seek to answer two questions. First, how are family background factors such immigrant status, ethnicity, and social class related to child health outcomes? Second, are there differences in health outcomes by neighborhood-level socioeconomic status, once individual and family differences are held constant? Among the child health outcomes we examine are the mother’s report of the child’s overall health status, reports of physician diagnoses of key chronic diseases (such as anemia and asthma), and, among children aged 12-17 years, body mass index adjusted for age as well as indicators of being overweight or at risk of overweight.

Among the 22 Arab countries, Egypt ranks amongst the worst for the treatment of women. Additionally, in the last 6 years, fertility surged to a 20-year high of 3.5 births per woman. Poorer women’s status and autonomy is often linked to high fertility; however, little is known about the factors that shape women’s autonomy and fertility in Egypt. This study evaluates determinants of women’s autonomy and the relationship between autonomy and fertility over time in a representative, longitudinal sample of women amidst a context of social transition: Arab Spring Egypt.

Theory suggests that certain life course events, like educational achievement are important in shaping women’s status and autonomy. Household and community effects on women’s autonomy have yet to receive needed research attention. The research is guided by the theory of gender and power and the life course perspective focusing on important events that shape women’s autonomy at multiple levels over the life course. Furthermore, the relationship between women’s autonomy and subsequent fertility behaviors is often assumed, but rarely studied over time. In this study, I look at women’s autonomy and fertility over time in Egypt.

Data come from the 2006 and 2012 Egyptian Labor Market Panel Survey (ELMPS), a nationally representative sample of households in Egypt and the 2008 Egyptian Demographic and Health Survey (EDHS). I use multilevel and standard OLS and Logistic regression models to show the relationship between individual, household, and community characteristics and measures of women’s autonomy and the relationship between women’s autonomy and fertility. Across all autonomy outcomes, region of household and household wealth are consistently associated with women’s autonomy. As expected, due to the greater social conservatism in Upper Egypt, the women in rural and urban Upper Egypt have less autonomy as compared to women in the Cairo region. The rural/urban differences in autonomy with women in rural areas being associated with less autonomy are also consistent with work that shows more patriarchal views in rural Egypt.

Results show the importance of women’s social context in Egypt in her level of control and ability to exercise autonomy in the household and greater community. Results indicate that women’s autonomy was greater in 2012 as compared to 2006, and that after the initial uprisings, women reported more household autonomy. While improvements in autonomy in 2012 could be temporary and the data need to cover a longer period of time to capture social changes, this shows some change in women’s status and behavior in the midst of social and political change. Regional variation shows more autonomy in Cairo and less in Upper Egypt. While these improvements could be temporary and the data need to cover a longer period of time, this shows some change in women’s status in the midst of social and political change. Contrary to what was expected, more autonomous women have a higher number of births. It may be that more autonomous women fulfilled social expectations of high fertility, although they personally desired smaller families.

This study makes significant contributions to the research on social and gender dynamics in modern Egypt. Additionally, this research uses a range of measures to operationalize autonomy, recognizing that each captures something different about a woman’s household experience. This study is one of the first to describe the household and social determinants of women’s autonomy and fertility in a transitional Egypt, specifically for a sample of women across the life course.

This paper examines the effects of family and neighborhood factors on child health in one of the largest urban areas in the United States, Los Angeles County. We use data from a new representative survey of neighborhoods and households in L.A.—the Los Angeles Family and Neighborhood Survey, or L.A.FANS—to examine the effects of family and neighborhood characteristics on child health status. A particular focus is on differences between Latinos and other race/ethnic groups as well as differences by duration of family residence in the U.S. and other key factors. We seek to answer two questions. First, how are family background factors such immigrant status, ethnicity, and social class related to child health outcomes? Second, are there differences in health outcomes by neighborhood-level socioeconomic status, once individual and family differences are held constant? Among the child health outcomes we examine are the mother’s report of the child’s overall health status, reports of physician diagnoses of key chronic diseases (such as anemia and asthma), and, among children aged 12-17 years, body mass index adjusted for age as well as indicators of being overweight or at risk of overweight.